Excludes1 pair

D53.9 vs D64.9

D53.9 and D64.9 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on D53.9
anemia NOS (D64.9)
D53.9

Nutritional anemia, unspecified

BillableUnspecified
Chapter 3
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
Section
D50-D53
Use when the record says
  • Simple chronic anemia
Indexed under
  • Anemia › deficiency
  • Anemia › macrocytic
  • Anemia › malnutrition
  • Anemia › nutritional (deficiency)
  • Anemia › simple chronic
D64.9

Anemia, unspecified

BillableUnspecified
Chapter 3
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
Section
D60-D64
Indexed under
  • Anemia (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
  • Oligocythemia
  • Anemia › atypical (primary)
  • Anemia › idiopathic
  • Anemia › normocytic (infectional)

Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027